The purpose of this work was to evaluate the quality of randomized controlled trials (RCTs) with acupuncture treatment for hepatitis B virus (HBV) infection. A systematic review of the literature for clinical trials was performed up to September 2008. RCTs assessing acupuncture point stimulation for patients with HBV infection were considered for inclusion. The search identified 70 relevant trials meeting the inclusion. The quality of each trial was assessed using the revised Consolidated Standards for Reporting of Trials (CONSORT) statement, facilitating critical appraisal and interpretation of RCTs by providing guidance to authors; the Standards for Reporting Interventions in Controlled Trials of Acupuncture (STRICTA) recommendations, acting as an extension of the CONSORT guidelines for the specific requirements of acupuncture studies; and the Jadad scale, widely used in different settings to assess methodological quality. All trials were reported "randomization", but only 2 mentioned the methods. None reported allocation concealment, a method used to keep clinicians and participants unaware of upcoming assignments. None reported blinding. 3 studies described the number of withdrawals/dropouts, while none used the analysis of "intention to treat". The reported items of the STRICTA recommendations were assigned for 65% (13 out of 20). Only 2 studies had a high quality Jadad score. The results from our work show that the quality was low caused by their methodological flaws and inadequate reports. Further rigorous clinical trials for HBV infection would be necessary to evaluate the efficacy of acupuncture.

Dept. of Orthopedic Surgery, National Taiwan University Hospital, Taiwan

Many treatment options for chronic low back pain are available, including varied forms of electric stimulation. But little is known about the electricity effect between electro-acupuncture and pulsed radiofrequency. The objective of this study is to assess the difference in effectiveness of pain relief between pulsed radiofrequency and electro-acupuncture. Visual analog score (VAS) pain score, the Oswestry disability index (ODI) to measure a patient's permanent functional disability, and Short form 36 (SF-36) which is a survey used in health assessment to determine the cost-effectiveness of a health treatment, were used as rating systems to measure the pain relief and functional improvement effect of pulsed radiofrequency and electro-acupuncture, based on the methodological quality of the randomized controlled trials, the relevance between the study groups, and the consistency of the outcome evaluation. First, the baseline status before therapy shows no age and gender influence in the SF-36 and VAS score but it is significant in the ODI questionnaire. From ANOVA analysis, it is apparent that radiofrequency therapy is a significant improvement over electro-acupuncture therapy after one month. But electro-acupuncture also showed functional improvement in the lumbar spine from the ODI. This study provides sufficient evidence of the superiority of pulsed radiofrequency (PRF) therapy for low back pain relief compared with both electro-acupuncture (EA) therapy and the control group. Bu the functional improvement of the lumbar spine was proved under EA therapy only. Both therapies are related to electricity effects.

Director of Medical Research, Heart Disease Research Foundation; Adjunct Prof., Dept. of Family & Community Medicine, New York Medical College; President and Prof., International College of Acupuncture & Electro-Therapeutics; Former Visiting Research Prof., Dept. of Electrical Engineering, Manhattan College; Former "Maitre de Recherche of INSERM", National Institute of Health & Medical Research of the French Government; Former Visiting Prof. & Research Consultant on Electroanesthesia, Electroanalgesia & Neuroelectricity, University of Rene Descartes of University of Paris

Yemeng Chen, LiAc, CMD, F.I.C.A.E

President & Prof., New York College of Traditional Chinese Medicine; Visiting Prof. of Acupuncture & Traditional Chinese Medicine, International College of Acupuncture & Electro-Therapeutics; Former Vice President, New York State Board of Acupuncture; Former Director of Acupuncture Clinic, Shanghai Medical University

Olivia Lermand, M.D., F.A.C.O.G., A.B.I.H.M., F.I.C.A.E.

Private Practice in Integrative Gynecology; Former Director of Colposcopy at St. Luke's-Roosevelt Hospital Center, New York City

Marilyn Jones, M.S., D.D.S., F.I.C.A.E.

Visiting Associate Prof. of Holistic Dentistry, the International College of Acupuncture and Electro-Therapeutics; Director, Wholistic Dental Center of Houston; Former Assistant Professor of Chemistry, University of Houston, Texas

Harsha Duvvi, M.D., MPH, F.I.C.A.E.

Assistant Prof., Dept. of Family & Community Medicine and Attending Physician of Neurology, New York Medical College; Visiting Associate Prof. to Integrative Medicine, International College of Acupuncture & Electro-Therapeutics

Our previous study indicated that when extremely reduced normal cell (NC) telomeres in various cancer patients are increased over 500ng BDORT units, abnormally high cancer cell telomeres and cancer-related markers such as Oncogen C-fosAb2 (Onco.) & Integrin α5β1 (Integ.) & 8-OH-dG as well as bacterial & viral infections, mercury, asbestos, chromium, & β-amyloid (1–42) markedly reduced due to improved circulation & excretion of these substances in urine. Since 1995, we have been using press-needle stimulation of Omura's ST36 with 200× press-release procedure 4× a day, with significant improvements in various cancer patients. In this study, Transcutaneous Electrical Stimulation (TES) at 60 pulese/min, which is close to patient's heart rate, was given between Omura's ST36 of both legs of the breast cancer and Alzheimer's patients. After about 10 minutes of TES, NC telomeres increased 1yg (=10-24g) to 500~525ng; Integ. reduced from 85~75ng to 0.5ng & Chlamydia trachomatis (CT) reduced from 4500~3500ng to 0.5ng. An additional 10 minutes TES increased NC telomeres to 800-875ng, while Integ. reduced to o.5yg & CT became less than 0.1yg. After a total 30 minutes of TES, NC telomeres increased to 1000-1200ng BDORT units, with decreased in Integ. and Onco. to less than 0.1yg. CT reduced to <<0.1yg. About 24 hours later, NC telomeres were still 300ng & both Integ. and Onco. were 2.5ng. CT was ~20ng. In Alzheimer patient, abnormally high β-Amyloid (1-42) of 7-12ng markedly reduced to within normal value of less than 1.5ng by 20~30 min TES. Stimulation beyond 30 minutes gradually reduced NC telomeres. TES pulse rate of 4 pulses/sec for the same patient initially increased NC telomere up to 750-950ng BDORT units within 20 minutes, but when stimulation continued more than 20 min, NC telomeres rapidly reduced to ~150ng in less than 10 min of TES with reduced beneficial effects.

Clinical Effectiveness of Acupuncture for Mandibular Subluxation and Dislocation

Dominic P. Lu, DDS, FICAE, FAGD, FRSH(Engl), FICD

Professor of Oral Medicine, University of Pennsylvania; Director of Medical and Dental Externship Education, Lehigh Valley Hospital/Penn State University of Medicine; President, American Society for the Advancement of Anesthesia in Dentistry

Dislocation or subluxation of mandible could occur suddenly without patient's awareness of its forthcoming. Patient may discover suddenly during yawning, laughing, or when the mouth is wide open that he or she could not close the jaw. It may cause severe anxiety and apprehension, that may put the patient in such a nervous state that may worsen the condition, and also may spastically tense the muscles associated with dislocation. We treated 37 patients in the past and found that, although five patients could be manipulated to have their dislocated jaw reduced to the normal state, we found that a majority of the cases could not be manipulated without supplementing with other adjunctive methods such as acupuncture at the pertinent acupoints or injections of local anesthetic around the temporomandibular joint area. Twenty-seven patients were successful to have the dislocation or subluxation reduced, five patients required local anesthetic for reduction and 1 patient had to have the reduction done in the operating room under deep sedation. We found acupuncture is valuable in reducing the mandibular subluxation and dislocation. Three acupoints in calming down the patients were a valuable aid during treatment. LI 4 which is known to reduce pain in head and neck could increase pain threshold and decrease anxiety associated with discomfort encountered during reduction treatment. Additional acupoints such as P 6 (Neikuan) Ext 1 (Yintang, and H 7 (Shenmen) are valuable for the patients who are tense and nervous. Those acupoints are also could be utilized as additional aid to ease the spasm of the muscles associated with subluxation and dislocation. Post-operative care includes stabilization at the head and neck region.